Sexual health information and support

People need information on STIs, contraception, sexuality, relationships and pregnancy. Often the basics of 'how to do' sex are also needed, as is a reassurance that sexual feelings are normal and that there is someone who will listen to their problems sympathetically.

Family Planning Clinics and GPs usually provide information people need about contraception, but sometimes people find out that they are not as well informed as they hoped. Even though many people feel shy talking about contraception when they're younger, by their late teens and early twenties most feel reasonably comfortable.

A level student who lives in a rural area. She says that in her area there is 'nothing' geared for young people regarding sexual health and family planning services.

For example, nobody told me that the Pill becomes, doesn't work if you're on antibiotics, nobody told me that, nobody told me that the Pill doesn't work if you have sickness and diarrhoea and I get irritable bowel syndrome when I'm stressed so nobody told me that and nobody told me that until last year when I had been on the Pill for four years that it doesn't work when those things happen.

Who told you at that point?

That was the doctor because I went in for some antibiotics and he said something about 'you're using a condom for sex aren't you', and I said what are you on about kind of thing and he said 'oh you do know that the Pill doesn't work when these things happen don't you' and I thought well that would have been nice to have known four years ago possibly, but, that kind of thing, they just expect you to know but if no one's taught you, you don't know these things, kind of thing.

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Profile Info

Age at interview:

25

Sex:

Female

Background:

Works full time as an account manager lives with her fianc'e and they are getting married next year. She wants to have children soon after that.

Oh yes, they were absolutely fantastic, they were brilliant. They went through everything with me. Any questions I had they answered, you know, any information they gave me.

I didn't feel intimidated, I felt very comfortable. I thought 'oh no, they're going to think I'm really young and what's a 14 year old doing in here' but as I was sitting in the waiting room there were other girls that seemed my age. You know, it was the vast majority of age groups and ranges there so I didn't feel so bad, they made me feel very comfortable.

Okay, so you got that support?

Yes, I got the support from there. After I'd been prescribed the contraceptive Pill I went home and I said to my Mum in the kitchen, I said 'Mum, I've gone on to the Pill' and she seemed a bit shocked and then we sat down and had a Mum and daughter conversation. And I said 'I've made a terrible mistake, Mum, I've lost my virginity' and she was very upset.

But I said 'I don't want to fall pregnant so I've gone on to the Pill' and she thought it was a fantastic idea because she had me when she was 16 so she was quite young as well. And she'd had 6 children and I think she thought, 'yes it's a good idea'.

There have been instances in which young people we interviewed have not felt well supported by health professional when dealing with issues to do with reproductive health. Natasha was told that she has an odd shaped womb that not only limits her choice of contraception but that can impact on her fertility.

Natasha recently graduated from university and does voluntary work for a charity organization. Single. Ethnic background' Indian

What is the name of the condition?

Oh I can’t remember. It has a really fancy medical name, really fancy name that I can’t remember. Even my doctor couldn’t remember. She was like, ‘Yeah your womb just looks like this. She would literally just do that, like that’s ok. And I had ultrasounds and everything because, because even after I got the implant out and, my periods started resuming the flow was a lot heavier than I’d expected. I’ve always had quite heavy blood flow and I just chalked it up to being normal and probably being a bit brown because that’s a standard thing. But then I thought it was a bit weird so I thought, ‘Oh ok, I’ll go to a doctor, see what happens’ and the doctor got that look on their face, ‘That’s about, no that’s not normal.’

So they sent me. They sent me in for an ultrasound which was really strange. I was like, ‘I’m not pregnant. Why am I having an ultrasound?’ But they, obviously they did that and they told me that, that’s how. I found out when I was 20 that I could potentially not have children or if I had more than one child I could die which isn’t something anyone wants to hear, you know.

No not when you are 20.

Right so it was a pretty dark time and I can’t, I don’t really talk to my parents about that kind of thing because it’s. I think it’s a culture thing like you don’t really talk to your parents about your sex life or the fact that, you know, your reproductive organs aren’t exactly at reproductive strength. And so it was pretty hard and obviously a lot of my friends don’t really understand and stuff.

And my, my gynaecologist [laugh] because I got referred to a gynaecologist she just treated me as some kind of medical oddity. She said, ‘Oh can I get the students to look at you. We’ve not had one of these before’. I was like, ‘Well given its 0.03% not surprised’. But I didn’t really feel comfortable with that so I said, ‘No’ which you can do. You can say ‘no’ to having them have the doctor watch you, prod you around like you are some kind of specimen which obviously I am but maybe do it after I am dead so I don’t really know that you are doing it to me and stuff. It’s…

Ok so you didn’t want the students there?

No just because I had only just, I’d only just heard about it and I was coming to terms with it and it felt like a full-on violation that something that I’ve only just realised and now you are getting other people to look at me

All, I’ll be honest with you the nurses were a lot nicer to me than the doctors I think.

The nurses were a lot more gentle. They were a lot more understanding, just nicer actually. I know that’s part of the job description. My mum is a nurse but the doctors were very impersonal, very, very impersonal and I was thinking, ‘You just told me a massive piece of news that could potentially change, you know, but you don’t really seem to care.

Detailed information about sexually transmitted infections (STIs) can be harder to find - and more embarrassing to ask for. Most of the people we talked to knew the names of the main STIs and would be concerned about an unusual discharge or smell, pains, urinary symptoms, lumps and bumps.

But there's often a lack of awareness of what symptoms go with what disease, or how serious they might be. People may even not talk about STIs with good friends - which adds to secrecy and feeling of stigma.

She is a full-time mum, has two children' one daughter of five and a half and a six-month-old baby. She became pregnant with her first child at the age of fifteen. (Played by an actor)

(The accompanying video and audio clips are played by an actor)

All you hear is like to prevent sexually transmitted diseases wear a condom, the pill does not stop sexually transmitted diseases and that's the only thing you hear. You don't hear anything about the diseases or anything like that, and you only hear like 'well if you use a condom you won't get any sexually transmitted diseases, but the pill don't stop sexually transmitted diseases' and that's all you all you seem to find out about with them really, use a condom to stop them but the pill doesn't stop them

So in your opinion do you think that there should be more detail in these classes?

Yeah I think they should, I think like until you know what it is or what can be done or what can't be done about it, apart from Aids but everybody knows HIV and Aids, but other things they don't know. So you tend, it doesn't tend to stick in your mind if you know what I mean, like oh yeah well you could get one, but you could not and then until you get one and find out what it is you're dealing with and things like that then you don't think about it.

I didn't really know what they were, it didn't play a part in my mind, that sort of thing. I was just like 'oh well'. And then you actually got one and you was like' but I think if I'd known more about them and what they are and how many different ones there are and things like that then I think it would've like opened my mind a bit more.

Talking with friends about sex can be very entertaining, reassuring and helpful, but sometimes leaves people feeling inadequate. They can be a source of practical advice and support, but, unlike doctors, nurses and NHS Direct, they are not always trusted to have the correct information. People we talked to did feel they could talk to health professionals, but weren't always certain what to ask them.

She finished secondary school and is taking a year out before going to University. She works full time and shares a house with other young people. (Played by an actor)

(The accompanying video and audio clips are played by an actor)

In your opinion what information do young people require but are not getting?

Well, I think you get told about contraception but you don't really get told about the emotional side of it really, and you can't really talk about it that much and you know, it's not a scary thing really' I don't know.

In your opinion what are areas related to sexuality and sexual behaviour that young people find the most difficult one to talk about or to seek advice about?

Well for me, I've got a low' pulling from past experience, I've got a low libido and you know, lots of my friends have these great, amazing relationships and I don't really feel like that at all. I'm not really sexually attracted to my boyfriend and it isn't really normal, I found it really quite embarrassing to talk about it, but you know if I could talk to my friends about it, they may have the same problem, but I don't really know because I think people would look upon me as like a freak.

Some people we spoke to liked using the internet for information because it is anonymous and private and can be used when issues seem too embarrassing to raise face to face. Young people also use the internet to gather information before discussing a particular issue with health professionals or, to complement the information provided by them. Young people we spoke to advised others to search official sites such as NHS Choices and Brooks website.

Victoria recently graduated from university and is currently seeking work. She would like to work with young people in the area of sexual health. Ethnic background' White British.

The internet is so useful, you can type in anything on Wikipedia and it will come up with it. Type in anything on Google and there's a million Family Planning clinics out there. NHS Health will tell you everything you need to know about every form of contraception that you want. Just that, all I did was type in, when I wanted the implant, I typed in 'implant' in Google and saw what came up. First entry Wikipedia, second entry NHS Health, it's not hard. I read a few books and I talked to friends before I wanted the implant to find out if any of them had it, whether it was good for them. One girl let me feel hers, you know, it was very easy.

Do you have any favourite sites that you would recommend to others?

NHS Health.

NHS Health?

I think it's very good because not only that but if you have a question about something, any illness on your body or if you're worried that you might have caught an STI especially then you can call them and leave your details and they'll call you back and discuss it, a registered nurse will call you back or you can email them your details and the registered nurse will call you back so it doesn't cost you anything. They will call you back, they will discuss it, they will tell you whether they think you might need to see a doctor and if they think you might need to see a doctor or a nurse about your problem they will make you an appointment for you. So it's completely and absolutely trouble free. Wikipedia – OK people, some people go around using their life to make fun of Wikipedia and messing up the Wikipedia articles and stuff. It's unlikely though if you go to one on the implants someone's going to have written something stupid on there. And it's always a very good source of initial information and if you typed in say the implant on Wikipedia it would have something like say, 'Links to the pill,' and 'Links to a condom' and stuff so you get to see all the other types out there as we’ll.

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Profile Info

Age at interview:

24

Sex:

Female

Background:

Works as a production assistant, lives with partner and she is looking for an alternative method of contraception to the implant.

I think I personally digest it better if I go and find out the information for myself.

And which websites do you tend to look at?

I just write into Google and look at anything that comes up which obviously then you go on Yahoo questions and have some 12-year-old tell you what they think but certain things like the Brooks website that I’ve been on a couple of times and I found that quite useful.

Sometimes there’s a, I believe it’s an American medical website that is like a diagnosis website. I think it’s called MedGP or something. I’m not entirely sure but it’s really easy to find with Google and you can go on it and write in symptoms and I find that quite a good medical website. Although I do take everything I read with a pinch of salt because I don’t want to start self-diagnosing myself for dreadful conditions.

And when you say that you found the Brook’s one a good one what do you think is good about it?

It’s not patronising. It’s, friendly. The way it is written is non-threatening and I think personally looking at it from someone who likes to look at it from a different perspective I think for younger people because when I go to Brook I feel like the oldest person there. Everyone else in the clinic is younger than me. I think people my age tend to have got a doctor sorted and go to a doctor but everyone else seems to be significantly younger. So I think it’s important that the website is written in a non-threatening way.

Mothers are often an important source of information for younger people, and most are happy to give advice, although some people don't like to ask, and others find their mum's don't always want to talk. Some people we interviewed talked to their mums about relationships, but avoid details of their sex lives, which both might find it embarrassing to discuss.

Student, living away from home for the first time. Wants to work, travel and would like to have children in the context of a relationship in her thirties. (Played by an actor)

(The accompanying video and audio clips are played by an actor)

Yes, and even sort of passing comments about sex as well, I don't really want to go into a detailed discussion. But yeah, it's really, really good when you can talk to your Mum about things, especially because your Mum knows a lot about life and she's got your best interests at heart as well. So those are the two main things for having a confidential discussion with her I guess.

I mean I could talk to my friends and they would be willing to listen, but they're all wrapped up in their own worries and I'd be the same if I spoke to them as well. I don't know, my mum's just really willing to listen to me for what I am.

Before I went to Uni I did talk to my' well, I did worry about when I should start having sex and whether I was being silly not wanting to start straightaway. Whether I should just go for it, I mean it wasn't really a big deal or it shouldn't really be a big deal, but you just worry about whether the guy is being faithful and whether he likes you as much as you like him, so I think those are the main things.

And these are the kinds of things that you talk to your Mum about with no problem?

Yes, well I mean when I worry about why he hasn't called, then my mum just tells me to stop being silly. So I don't like to tell her things like that, but I tell my mum the big things and my friends the little things, because you don't like your mum to tell you that you are being stupid.

And what about your Dad?

No, I want my Dad to think that I'm completely innocent and pure and not to worry about me. He would just tell me that none of the boys are worth worrying about and that I should dump them all anyway! So no good at all.

Like a good Dad?

Yes, I mean he'd just tell me that I was wasting my time with all these boys.

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Profile Info

Age at interview:

24

Sex:

Female

Background:

Black Caribbean young woman who works full time in the administrative sector. Since starting her sexual life she has used contraception. Her primary concern has always been to avoid unwanted pregnancy. (Played by an actor)

(The accompanying video and audio clips are played by an actor)

No, I don't think so. I mean I'm not really a shy person, so if I want to know something I'll ask, so no. If I'm worried about something or needed something, I've always come here or gone to my GP. I don't think I'd go to my Mum, because I think she'd start squirming. So I've always come to the doctor or come here.

No, I mean my mum's a squirt, unbelievably. I was teasing to her before, and I was saying, 'Mum why have you never told us about the birds and bees?', and she said, 'Well you learnt it at school'. And I said, 'Well that's not the point. Maybe I wanted to hear it from you'. And she was just squirming. And I was like, 'It's alright Mum. If you need to know anything, I'm here'.

She's embarrassed to talk about sex?

I think so, I don't know why.

Well, some parents are.

I don't know why she is. She's really' what's the word'. very outgoing, so it does surprise me that she's a bit embarrassed to talk about stuff like that, because she is so loud and crazy and outgoing.

Magazines like Just Seventeen (for young teenagers) and Cosmopolitan were an important source of 'sex tips' for the girls we interviewed, which they discussed with friends. Boys whose sisters had copies of girls' magazines lying around the home usually took a peek and wondered how men without sisters manage.

A couple - An Australian student who says that he learned a lot about sexual health from reading his older sister's magazines. He cannot understand how guys with no sisters cope or where they get their information from.

Do you think that young men have enough information about contraceptives?

B' It's a good question. I tend to think of myself as educated but I have a sister and I used to always take an interest in what she was reading in her magazines so I kind of found out a lot of information that way. But as for men in boys' magazines and things, you don't really see any information on contraception, I don't know. But I haven't bought a magazine for a long time so '

G' You just read your sister's!

B' Yeah!

So how old were you when you started reading your sister's magazine?

B' Well I guess when she became a teenager, when she started buying magazines like Cosmo and all those girly magazines. Teenage girl magazines, so I was only 9 or 10 or so.

According to the women we talked to, young men varied in their knowledge of contraception, with some being aware, other's being relatively 'clueless'.

A level student who lives in a rural area. She says that in her area there is 'nothing' geared for young people regarding sexual health and family planning services.

99% of blokes that I know think that withdrawal is an efficient, an effective method of contraception for example.

And that is the majority of boys that I know, and these are intelligent boys, they're doing 'A' levels or they're doing good jobs and they think that that is a 100% effective, so I don't think that they get taught enough, or if they are getting taught, they're being taught the wrong things because it's not effective.

They think that the Pill is a 100% effective, I know boys who think that the Pill protects you against STD's, I know boys who think that condoms are manufactured so that they cannot split and that it doesn't ever, ever, ever happen and I just don't think that they're educated enough at all.

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Profile Info

Age at interview:

21

Sex:

Female

Background:

Lives in shared accommodation with two other friends and works part-time as a barmaid and studies at University.

I don't know. I talk to my male friends about sex a lot as well actually and I often get the impression when I talk to them that they don't really have those kind of conversations very often, like it's kind of quite, they're quite shocked by the fact that I'm prepared to talk about it. I think girls are a lot more open.

And I think boys may be wouldn't want to admit to having done anything wrong in bed, or had any embarrassing experiences whereas girls are a bit more willing to just kind of go "Oh my god I did this the other night," or "this happened and it was really embarrassing."

Most blokes always have that kind of macho thing of not wanting to, I don't know admit they were wrong or admit they might have done something silly or whatever so that's probably a problem.

In your opinion what information do young people require but are not getting?

Boys could do with the kind of sex tips you get in Cosmopolitan, they could do with a magazine with those kind of things in because Cosmopolitan is very, very useful for girls I think to kind of... whereas boys, a lot of boys don't really understand girls very well I don't think and kind of what girls like in bed.

And obviously it varies a lot from girl to girl as well but I think there are some things that it's quite, you know obvious. And girls will exchange sex tips much more readily than boys will I think, because of the macho thing I think blokes wouldn't want to admit they wouldn't know how to do something whereas a girl would be quite happy to say to a friend "Oh you know, how do you give a blow job?" or like "What do you do when you do this?" without being embarrassed about it.

So I think boys could probably do with some way in which they can kind of find out about stuff like that, other than girls having to teach them which tends to be what happens I think. Which is okay I suppose at least it happens, but I don't know.

Both boys and girls need to know about each other. Good sex education is needed in schools as well as mass media advertising about safe sex and contraception. Different approaches are needed to ensure everyone finds out what they need to know.

Student who experienced Chlamydia the first time she slept with her first boyfriend. He did not know he was carrying the infection. Both were successfully treated. (Played by an actor)

(The accompanying video and audio clips are played by an actor)

I think as girls, they are also given education at school but they are more about the mechanics of girls rather than the feelings of girls. They sort of have quite a few misconceptions about periods, you know, get your period, lasts a day, go to the toilet, end of story, you know they need a bit more guidance.

I think also, for me, I know how girls work but I wasn't sure on the mechanics of the boys, you know how they feel about things and what they go through puberty and everything, so I think more information for both parties would be better.

I don't think they have sufficient information about girls and the mechanics of girls

I think obviously when you're in a sexual relationship, you learn about each other and each other's bodies and how you know, I might not want sex or I've got my period or something like that. I was quite shocked when my boyfriend told me that he hadn't had sex for 6 months and so things might go quite quickly'

It hadn't occurred to me that things like this would happen, I'm not quite sure if that's just me being naive or whether everyone feels this way.

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Profile Info

Age at interview:

21

Sex:

Female

Background:

She was brought up in a rural area. Currently at University she has worked for several years as a peer educator for the sex education programme' A Pause.

What would be the best way for teenagers to receive information about contraception and sexual health?

The best way would be in a number of ways, you know, let's say that A Pause went in for schools and did their sessions at that age, you know what if someone's ill or what if someone's ditching school?

I don't think, on its own, even that is not necessarily enough, school is the best way to reach most people, you know, if possible countrywide. But you know there's lots of other ways of doing it, not necessarily instead, but as well would be great.

You learn inadvertently from your friends, from magazines anyway but you know, youth centres. The thing is with doing it in schools, you reach more than you can in any one other area but not necessarily everyone, and it might be the ones that aren't there that might need it most so...